7.4.6 At Risk Pregnancy

The ARP placement is for a pregnant woman in her 3rd trimester who is diagnosed with an At Risk Pregnancy. The participant receives a monthly payment of $673. A pregnant woman in an ARP placement must not be subject to requirements of W-2 employment positions, such as Employability Plans (EPs), sanctions for nonparticipation, etc. Pregnant teens younger than eighteen (18) years are not eligible for an ARP placement.

7.4.6.1 ARP Eligibility Requirements

A pregnant woman who meets all of the following requirements must be placed in an ARP placement:

· Meets W-2 financial and nonfinancial eligibility requirements, except the woman is not a Custodial Parent (CP) of a dependent child who resides in the woman’s home;

· Is in the third trimester of pregnancy, defined as the twelve weeks prior to the estimated delivery due date, which must be medically verified (see 7.4.6.2);

· Is unable to work as a result of the at risk pregnancy, and the inability to work due to the at risk pregnancy must be medically verified.

The following W-2 nonfinancial eligibility criteria does not apply to ARP Eligibility:

“Have made a good faith effort, as determined by the W-2 agency on a case-by-case basis, to obtain employment and have not refused any bona fide offer of employment, including a job quit, within 180 calendar days immediately preceding application. (See 2.2.1, #8)

EXAMPLE: Sophia is seven months pregnant with her first child and has never been married. Sophia’s doctor recently ordered Sophia to bed rest for the remainder of her pregnancy to treat problems in Sophia’s medical conditions that developed from Sophia’s pregnancy. Sophia contacted the local W-2 agency for assistance. The W-2 agency provided Sophia with information about W-2 and ARP, and Sophia indicated she wanted to apply. While Sophia is on bed rest, the FEPFinancial and Employment Planner contacted Sophia by phone and went to Sophia’s home to complete Sophia’s W-2 application. The FEP determined Sophia is eligible for W-2, except without custody of a minor child which is not a W-2 requirement for an ARP placement. The FEP gave Sophia an ARP Medical Information/Verification Form for Sophia to provide for her doctor’s completion and return to the W-2 agency. The W-2 agency already had filled in the form with: (1) The W-2 agency’s name, address, telephone and fax numbers; and (2) Sophia’s name and birthdate. Based on the information from Sophia’s doctor in the completed form, and the information Sophia already had provided to the W-2 agency, the FEP placed Sophia in an ARP placement.

7.4.6.2 ARP Medical Information Requirements

The required medical information/verification for ARP must be provided on either:

· Letter/memo from the physician on the physician’s letterhead that includes all of the information described below.

The required medical information/verification must be provided by the patient’s physician based on the physician’s medical examination of the patient. The physician’s specialty area must be one of the following: General Medical; Family Medicine; or Obstetrics.

The physician’s signed statement on either the ARP Medical Information/Verification Form or on the physician’s letterhead must be completed no earlier than thirty (30) days prior to the beginning of the pregnant woman’s third trimester of pregnancy. Medical information/verification completed earlier must be resubmitted and updated by the physician within the required time frame.

EXAMPLE: Christa is pregnant with her first child and is currently on bed rest because her pregnancy is high risk. She is in her first trimester when she applies for W-2. Christa is placed in a CMPCase Management Pregnant Women placement. It is possible that her medical condition could change between her first trimester and her third trimester when she may become eligible for an ARP placement. Therefore, Christa has to obtain an updated medical information/verification no earlier than thirty (30) days prior to the beginning of her third trimester of pregnancy to be eligible for the ARP placement.

3. Patient’s estimated due date (which must be provided by the patient’s physician);

4. Physician’s statement that the patient is in an at risk pregnancy (which the patient’s physician must provide based on the physician’s determination of an at risk pregnancy);

5. Physician’s statement of the cause/reason for the physician determining the patient’s pregnancy is an at risk pregnancy;

6. Physician’s statement that the patient is unable to work due to the patient’s at risk pregnancy;

7. Start date for the patient being unable to work due to the at risk pregnancy;

9. Physician’s specialty area (which must be General Medicine, Family Medicine or Obstetrics);

13. Date of the physician’s signature (must be no earlier than thirty (30) days prior to the beginning of the woman’s third trimester of pregnancy); and

14. Physician’s contact information: e-mail address; phone number; fax number; and office address.

NOTE: The W-2 agency may verify a National Provider Identifier (NPI) based on a medical provider’s name or may verify a medical provider’s name based on an NPI by accessing the NPI Registry website at: https://npiregistry.cms.hhs.gov/.

The W-2 agency must date stamp the ARP Medical Information/Verification Form or the physician’s letter with the date when the W-2 agency received the document.

7.4.6.3 ARP Placement/Payment Start Date

· Start date of the third trimester defined as twelve weeks prior to the medically verified estimated delivery due date; or

· Date specified by the physician in the ARP medical information/verification as the start date of the patient’s inability to work due to her at risk pregnancy.

7.4.6.4 Child Support Requirements and the 60-Month Federal Lifetime Limit

ARP payments do not require cooperation with child support or the assignment of Child Support payments. ARP placements do not count towards the 60-month federal lifetime limit because the payment is considered short term assistance under TANF regulations.

If an ARP participant transitions to another placement, the child support rules and requirements for that placement should be implemented when the participant changes placements.

7.4.6.5 ARP Case Management Requirements

The W-2 agency must contact ARP participants at least once a month. These contacts must be initiated by the W-2 agency. The contacts may occur in-person or by phone depending on the needs of the ARP participant.

The purpose of the monthly contact is to discuss the ARP participant’s needs. The W-2 agency must provide W-2 services or refer the participant to other agencies/services to meet her needs. For example, discussion with the ARP participant may reveal that periodic visiting nurse services may be helpful, and then the W-2 worker would follow-up with a referral for those services.

7.4.6.6 Ending ARP Placement/Payment

· When the ARP placement changes to a different W-2 placement, for example the placement change to a Custodial Parent of an Infant (CMC) placement when the woman’s child was born.

· If an ARP participant regains custody of a dependent child, the ARP participant may be eligible for a W-2 Transition (W-2 T) placement.

· When one or more of the five ARP eligibility requirements are no longer met. Examples include: the participant regained custody of her minor child; the participant got married; or the participant is no longer pregnant.

· When CARES batch process ends the ARP placement; this is twenty (20) days after the estimated due date.